Utility of PET/CT in the diagnosis of recurrent ovarian cancer depending on CA 125 serum level

Nuklearmedizin. 2015;54(4):158-62. doi: 10.3413/Nukmed-0709-14-11. Epub 2015 Jun 16.

Abstract

The aim of this study was to estimate the diagnostic value of common application of CA 125 level measurement and 18F-FDG PET/CT examination in patients with a suspicion of recurrent ovarian cancer.

Patients, methods: A retrospective analysis was performed on a group of 68 patients aged 31-77 (average 57.7) with a suspicion of relapsing ovarian cancer who had CA 125 serum level measurement and PET/CT examination done with a maximum interval of 60 days.

Results: PET/CT examination result was positive in 33 patients (48.5%) and negative in 35 (51.5%). Level of CA 125 was significantly higher in women with a positive PET/CT result than in patients with a negative one (average 199.9 U/ml and 15.7 U/ml, respectively, p < 0.001). Nevertheless, comparison of CA 125 level in groups defined according to the localization of the relapse showed no significant differences. Moreover, the ROC analysis revealed that the optimal cut-off point of CA 125 concentration to predict positive PET/CT result was 17.6 U/ml. Area under the curve was 0.91. Sensitivity, specificity and accuracy in prognosticating positive PET/CT result for the selected cut-off point of 17.6 U/ml were 90.9%, 80.0% and 85.3%, respectively.

Conclusion: CA 125 level does not depend on the localization of the recurrence. PET/CT is particularly useful in patients with a suspicion of relapsing ovarian cancer with CA 125 value of at least 17.6 U/ml.

Keywords: 18F-FDG; CA 125; Ovarian cancer; PET/CT; diagnosis; recurrence.

MeSH terms

  • Adult
  • Aged
  • Biomarkers, Tumor / blood
  • CA-125 Antigen / blood*
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Image Enhancement / methods
  • Middle Aged
  • Multimodal Imaging / methods*
  • Neoplasm Recurrence, Local / blood
  • Neoplasm Recurrence, Local / diagnosis*
  • Ovarian Neoplasms / blood
  • Ovarian Neoplasms / diagnosis*
  • Positron-Emission Tomography / methods*
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed / methods*

Substances

  • Biomarkers, Tumor
  • CA-125 Antigen
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18